The Good Life Letter

Despite the best efforts of global warming and the antics of the ‘frackers’ in the North, our weather in Blighty is set to be as it has been for thousands of years over the late Autumn and Winter seasons.

Dark!

Forgive me stating the obvious but I think it is worth bearing this simple fact in mind before I embark on today’s letter. I need to do it to try to keep my blood pressure and temper in control as far as I can.

You see, I am convinced that the British press is trying to give me a heart attack!

Last week I vented my spleen against the concept of pre-diabetes and how this is just a way to scare us into taking more pharmaceutical products than we need to.

Then this week I read in the Mail on Sunday that Vitamin D supplements are a waste of money. In fact, what the headline said was “Why scientists say government advice to take the sunshine vitamin this winter is total bunkum.”

I couldn’t believe my eyes.

There was me thinking that this, at least, was an argument that the natural health lobbyists had won, and even the government health advisors were saying we should all take some at this time of year.

The reason being (and I hate to sound repetitive) that we don’t get the sunshine we need to allow us to make this important vitamin.

But no, apparently a new study published in the Lancet by a team from Aukland University combined with Aberdeen University concluded that the results of some 30 new trials since 2014 didn’t show any benefits for skeletal structures from taking vitamin D supplements.

They said, “Our meta-analysis finds that vitamin D does not prevent fractures, falls or improve bone mineral density, whether at high or low dose.”

Wow, that really does fly in the face of everything else that I thought I understood.

Right, time to start to rebuild my faith in the vitamin D story, starting with the basics...

Hold onto your hats as I need to explain some pretty complex physiology, but I will try to simplify it for you...

Firstly, vitamin D isn’t a vitamin as far as the body is concerned, it is in fact a hormone but please don’t let that worry you.

Under the right conditions (remember the sunlight thing!) our bodies are capable of making 90% of the vitamin D that we need – the other 10% we get from oily fish, eggs and offal (if we eat them...especially bad news for vegetarians).

Ultra Violet B light (UVB) hits our skin and a chemical which is a derivative of cholesterol (yes, the stuff that we are constantly told is bad for us!) undergoes photolysis and gets converted into ‘Pre-Vitamin D3’ (cholecalciferol) which bonds to a circulatory protein.

This ends up in the liver which converts it to another precursor compound called calcidiol (25(OH)D) which enters the circulation and can be measured in blood tests for assessing whether we are deficient.

Finally, the various tissues of the body and especially the kidneys convert this calcidiol into Activated Vitamin D (calitrol), and it is this which has all the remarkable impact on our health we desire, acting as a hormone in doing so.

Forgive me for all that, but I need to ensure that we all understand how nuanced the processes are that this vitamin goes through – no-one can say it is a simple story!

So, this is a vitamin that is really a hormone...

...next I want you to understand that the effect it has on bone strength is not really what its most important role actually is.

This might also sound at odds with what you previously understood, but let me explain.

Everyone understands that levels of vitamin D help the body conserve calcium, and most people recognise that this mineral is one of those which is important to keep our bones and teeth in good order.

But in reality calcium has a more significant role to play in the way our nerves and muscles work – our bones are just a store for the body to allow these important systems to do their jobs.

Bone strength is one feature of vitamin D at work, but having the right levels available is key to the correct functioning of:

The immune system – allowing us to fight off winter coughs, colds and the flu.

I am always intrigued when a piece of information makes the news which offers a radical change in thinking.

In some instances these new studies can be ground breaking and really do make me sit up and take notice, but so many others are flawed, deceitful and often commercially motivated and I suspect that the latest news about vitamin D might be one of them.

Many of these trials are flawed because they involve too few participants and therefore the results can easily be skewed, however, this study doesn’t suffer from this common error as it was a meta analysis of 81 trials covering many thousands of individuals...

...but: only four of those trials included people who were known to be deficient in vitamin D in the first place.

Surely if you are fresh from a summer sun, in the prime of health and have no restrictions to diet then taking any supplement is not going to make much difference.

But if you happen to be older, in a dark winter and don’t eat a diet of fresh oily fish, liver and egg yolks then chances are you need the extra vitamin D.

Other experts agree with me on this.

Prof Adrian Martineau, of Queen Mary University of London, said the findings "do not provide any reason to revisit or reconsider" current advice.

And Prof Martin Hewison, from the Society for Endocrinology, said, "Almost all trials for vitamin D supplementation have shown that supplementation is only effective if you are vitamin D deficient to begin with.”

And this is where the final fact of the day comes to bear... in huge population studies carried out across the UK over the last decade, 1 in 5 people are deficient over the winter months.

This is particularly the case for the elderly, those on restricted diets and anyone who hasn’t spent the summer in the garden with their shorts on... that sunshine thing once again.

So, I would argue that far from showing supplementation at this time of year is a waste of time, this study demonstrates only that science can be flawed.

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